Diastasis Recti – How To Fix Ab Separation During Pregnancy

During pregnancy, your body has many ways of surprising you.

You experience weight gain, changes in your skin, back pain and breast tenderness. They’re all part of the physical changes that come with pregnancy.

One of the more surprising changes is how your body actually makes room to accommodate your growing baby.

Most pregnant women look forward to seeing their belly grow. They are usually less excited, though, to find out their abdominal muscles might separate as a result.

Abdominal separation during pregnancy is called diastasis recti, and it affects about 1 in 3 mothers.

Some mothers aren’t aware they have it; others might not know how to treat it correctly.

Here is everything you need to know about diastasis recti, and how to fix ab separation during pregnancy.

What is the rectus abdominis muscle?

The rectus abdominis muscle is made up of two parallel muscles separated by a band of connective tissue called the linea alba.

These muscles start at the rib cage and extend down to the pubic bone at the front of the pelvis.

They form part of a group of abdominal muscles, which support the trunk of your body, help keep your body stable and balanced, and protect your spine.

What causes diastasis recti during pregnancy?

During pregnancy, your body makes a hormone called relaxin. This allows your connective tissue to soften and loosen.

As your baby grows, the uterus pushes against the abdominal wall and the connective tissue between the rectus abdominis muscles starts to relax.

As your baby gets bigger throughout your pregnancy, the pressure from your uterus pushing against the abdominal wall increases.

As the pressure increases, the right and left sides of the rectus abdominis muscles begin to widen at the linea alba between the muscles. This causes a gap to appear between the two sides of the muscle.

This ‘gap’, or muscle separation, is technically referred to as diastasis recti abdominis.

Who is at risk for diastasis recti?

As previously explained, the main cause of diastasis recti in pregnancy is the increasing pressure from your growing uterus against your abdominal wall.

As well as this, there are several risk factors that increase the likelihood of diastasis recti occurring.

These are:

• Previous pregnancy that caused muscle separation
• Multiple pregnancy
• Being overweight or obese
• Having a petite frame
• Pronounced swayback
• Poor abdominal muscle tone.

Any of these factors can make it more likely you will experience diastasis recti during pregnancy.

What does diastasis recti feel like while pregnant?

During pregnancy, there are a few signs that you might have diastasis recti.

You might feel a gap, or even a bulge, at either side of the midline of your belly, around your belly button.

You might notice that when your abdominal muscles are ‘switched on’ your belly no longer looks round, but appears to be cone-shaped instead.

The picture below shows an example of a woman’s pregnant belly in the typical rounded shape while she is relaxed. When she attempts to sit up, using her abdominal muscles, the coning associated with diastasis recti is visible.

*Insert picture*

It’s advised to avoid any exercises that cause ‘coning’ during pregnancy, as they could cause further damage to the abdominal muscles.

If you think you might have diastasis recti while pregnant, you can ask your GP, midwife, obstetrician or women’s health physiotherapist to check.

How do you check for diastasis recti when pregnant?

You can also check at home whether or not you have a diastasis recti separation.

Follow these steps:

1. Lie on your back with your knees bent at a 45-degree angle. Make sure your pelvis isn’t tucked and your spine is relaxed. Practice taking some deep breaths from your diaphragm.
2. Contract your pelvic floor muscles (as though you were stopping the flow of urine) and exhale. Then lift your head, tucking your chin towards your chest.
3. Starting just below your rib cage, walk your fingers down towards your belly button. If there is a gap in the abdominal muscles you should be able to feel the area where they separate. If you feel fatigued, stop and rest, and start again from step 2.
4. Push the space where you can feel a gap between your ab muscles. If you have diastasis recti, the area will feel soft and spongy, not strong and tight.

Separation is measured by the number of finger widths that fit between each side of the muscles. If there is space for two or more finger widths, it is considered to be diastasis recti.

Is diastasis recti common in pregnancy?

Diastasis recti is very common in pregnancy. It’s believed around 70% of women will experience it to some degree.

Women who have a direct relative who experienced diastasis recti are more likely to have it themselves.

Although it’s a common condition during pregnancy, it can also occur in people who aren’t pregnant.

Diastasis recti can also occur in children, due to a weak spot in the connective tissue which joins the two sides of the rectus abdominus muscle.

Men who lift excessive weight incorrectly or who perform unsafe or excessive abdominal exercises might also experience diastasis recti.

How can I prevent diastasis recti during pregnancy?

Although it’s impossible to prevent your growing baby from putting pressure on your abdominal wall during pregnancy, there are steps you can take to minimize the likelihood of diastasis recti occurring.

It’s also possible to reduce the amount of separation that occurs in your ab muscles and to make sure your body returns to normal after the birth of your baby.

Before pregnancy

Prior to pregnancy, ensure your posture is correct. Incorrect posture becomes a habit and leads to instability of the core muscles. Your stomach muscles assist in so many movements that can be affected by poor posture.

Be aware of your posture during daily activities, such as pushing a shopping trolley. Rather than pushing through your arms and shoulders, you should be letting your legs and glutes do the work.

Any abdominal exercise training you should be done correctly. If you need help correcting any postural problems, seek support from an osteopath or physiotherapist.

Women who have a higher BMI increase the risk of having a muscle separation. If you take steps towards healthy weight loss, this risk is reduced, and you will also improve your chances of a healthy pregnancy and an intervention-free birth.

During pregnancy

During pregnancy, always keep an eye on your posture. Over time bad posture can lead to weakened abdominal muscles and lower back pain.

Pregnancy-specific exercises for strength and postural correction can help.

Avoid exercise training activities that place more internal pressure on the abdominal walls, such as planks, sit-ups, and push-ups.

Seek out a trainer, or find an exercise program that is specific for pregnancy, and ensure these exercises are not part of the routine.

Pelvic floor exercises are a particularly important factor during pregnancy.

For some great tips on how to fit pelvic floor exercises into your daily routine, you can read BellyBelly’s article 7 Great Times To Do Your Pelvic Floor Exercises

After pregnancy

The separation usually occurs in the third trimester, but it can also happen after pregnancy when the abdominal wall is weakened and there isn’t a baby inside to support the muscles.

After pregnancy, symptoms of diastasis recti can include:

• Lower back pain
• Pelvic pain
• Leakage of urine when coughing or sneezing.

If you have a diastasis recti from a previous pregnancy, see a medical professional or postnatal physiotherapist, who will help you close the separation as soon as possible.

By doing this you will reduce your chance of another separation, or increased diastasis recti, in subsequent pregnancies.

Can I fix the diastasis recti while pregnant?

There are many factors during pregnancy that can lead to diastasis recti.

Some of these, such as poor posture, are easily fixed; others – for example, being pregnant with multiples – are unavoidable.

Many women don’t have any symptoms but no amount of exercise and dieting improves their belly.

Exercising when you have diastasis recti means you could be relying on other muscles to do the work your core should be doing. Over time, this instability could lead to injury.

If you are dealing with abdominal separation during pregnancy, exercises such as planks, crunches and burpees aren’t recommended.  These exercises place a lot of internal pressure on already weakened muscles.

With so much conflicting information on the Internet, it can be hard to know which are the correct exercises to do.

That’s why it’s a good idea to seek the advice of your care provider or someone who specializes in women’s health or physiotherapy.

Diastasis recti pregnancy complications

Abdominal separation during pregnancy can lead to further problems after birth.

Some of these are:

• Hernias
• Back pain
• Pelvic pain
• Pelvic floor dysfunction (urine leakage)
• Constipation
• Damage to posture
• A protruding pregnant-looking belly, post-pregnancy.

Ongoing postnatal physiotherapy can address the separation and limit complications.

Does diastasis recti go away?

In most cases, diastasis recti heal on its own over a period of 6 weeks to 3 months after birth.

Your uterus will return to its pre-pregnancy size and relaxin will leave your body by about 3 months postpartum. Your separated ab muscles will return to their original space, although there’s usually a finger width gap.

Smaller separations tend to decrease easily with exercises you can do at home, but it’s important you choose a program that is reputable and has been designed by someone who is experienced in corrective exercise.

If you give mindful attention to your body posture and do the correct exercises, you can limit the extent of separation.

If you have any muscle separation, recovery, after your baby is born, is important. Speak to your care provider about being referred to the support services which can best help you.